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Biomedical subjects

R B Margolis

Publications and source records attributed to R B Margolis.

At least 19 recordsLinked to original sources
PubMed1992

The effect of a single low dose of trihexyphenidyl on memory functioning in the healthy elderly.

Medications with anticholinergic properties, when taken at therapeutic doses, are known to adversely affect memory functioning in young adults and the elderly. However, their impact at lower doses in geriatric persons has been less thoroughly studied. We investigated the impact of a single 2-mg dose of trihexyphenidyl on memory functioning in 20 healthy elderly subjects using a within-subjects, double-blind comparison with a placebo. Memory functioning was evaluated using subtests of the Wechsler Memory Scale. Subjects also rated the perceived impact of medication on their performance following memory testing. Results indicated that the single 2-mg dose of trihexyphenidyl produced impaired performance on measures of immediate and half-hour delayed recall of complex verbal and visual material when compared to the placebo condition. However, differences were not found on several other memory measures, including general orientation, attention-concentration, and learning of word associations. The significance of these selective memory deficits and suggestions regarding future research are discussed.

Aged↗
PubMed1992

The relationship of anger, depression, and perceived disability among headache patients.

Depression is a common concomitant of headache. Conflict with regard to anger or the expression of anger has also been discussed in terms of its relationships to headache. The direction of the relationship between headaches and depression and/or anger is not clear from available research literature. Thus, the present study proposed to examine the interrelationships among measures of anger expression, depression and self-reported disability in a sample of chronic headache patients. It was predicted that there would be significant correlations between depression and perceived disability, and anger held in and perceived disability. Finally, it was predicted that anger held in would be shown to impact perceived disability by way of its relationship to depression. Path analysis was employed to investigate the relationships among the variables. Results showed a significant and positive relationship between depression and perceived disability, which supported the first hypothesis. Anger expression was not significantly related to perceived disability. Therefore, the second hypothesis was not supported. Anger-in, however, was strongly and positively related to depression. Although the causal direction of the relationships cannot be stated with certainty, the suppression of anger appears to be a moderating variable that amplifies the experience of depression among chronic headache patients.

Adult↗
PubMed1990

Prevalence of temporomandibular symptoms in a large United States metropolitan area.

The prevalence of five symptoms of temporomandibular disorder and associated symptoms of pain, headache, and stress was estimated in a random telephone survey of a large United States metropolitan area. The prevalences for nocturnal bruxing, joint noise with use, soreness on waking, soreness with use, and diurnal clenching were roughly equivalent (ranging from 8% to 12%) and were within the range of prevalences reported in previous studies. Overall, 149 of the 500 respondents reported one or more of the five symptoms. Symptoms were not more prevalent among women than men, but were more prevalent among younger respondents. Soreness on waking and daytime clenching were the only symptoms significantly associated with report of pain. Pain was more commonly reported by respondents with multiple (four or five) symptoms. The results are compared with those of previous random surveys, and limitations to generalization of the present findings are discussed.

Adult↗
PubMed1990

WAIS-R performance in dementia with and without depression.

A lower mean WAIS-R Performance IQ and lower mean scores on the Arithmetic and Picture Arrangement subtests for dementia patients with affective disorder (n = 22) versus dementia patients without affective disorder (n = 10) are presented. Implications of these findings and suggestions for further research are tendered.

Aged↗
PubMed1989

Pain distribution, intensity, and duration in patients with chronic pain.

This study examined the impact of two dimensions of pain distribution (extent, site) on patient reports of pain intensity and duration among 105 patients with chronic pain. Pain extent was found to be associated strongly with reports of pain intensity and pain duration. When variance associated with pain extent was controlled, however, pain site was not associated with reported pain intensity, a finding inconsistent with previous research. Possible explanations for this inconsistency are discussed, and directions for further research are proposed.

Chronic Disease↗
PubMed1989

Prevalence of very severe headache in a large US metropolitan area.

Reliable data regarding prevalence of headache, in general, and migraine, in particular, remain elusive. Methodological inconsistencies and inadequacies are largely responsible. The present study uses a random sampling technique to assess the prevalence of very severe headache. Estimates of headache prevalence were obtained for two time periods: indeterminate/lifetime and the past three months. The resulting prevalence estimates were 20.4 and 15.2%, respectively, for women, and 11.2 and 8.8%, respectively, for men. The estimates are compared with those of previous studies. The present study is compared with these previous studies and suggestions are offered for future research. Aspects of the treatment experience of respondents with poorly controlled headache are also addressed.

Adult↗
PubMed1989

The sensitivity of the Bender-Gestalt Test as a screening instrument for neuropsychological impairment in older adults.

We investigated the sensitivity of the Bender (1938) Visual-Motor Gestalt Test (BGT) using the Halstead-Reitan Neuropsychological Battery (HRB) as the criterion for cortical dysfunction. We studied 95 subjects over age 55 who had been diagnosed as having dementia or pseudodementia. Subjects were classified as mild, moderately, or severely impaired on the HRB and as impaired or unimpaired on the BGT. The results indicated that the BGT is less sensitive (36%) than was expected when used on an impaired geriatric population. The data further indicated that false negatives occurred more frequently with the BGT when individuals had mild neuropsychological impairment. Less frequent misclassifications occurred as the severity of impairment on HRB indices increased.

Aged↗
PubMed1989

Correlation of two competence assessment methods in a geriatric population.

A 10-subscale version of the Community Competence Scale, a structured interview, and the Scale of Competency in Independent Living Skills, a rating scale completed by a relative, were administered to 40 geriatric patients with suspected dementia. While the two assessments of competence appear to examine a common global domain, individual correlations between subscales of the two measures were only moderate. The findings provide limited support for the construct of competence.

Activities of Daily Living↗
PubMed1989

Relation of cognitive functioning to daily living skills in a geriatric population.

A modified version of the Community Competence Scale was administered along with the Wechsler Adult Intelligence Scale--Revised (WAIS--R) to 40 geriatric patients with suspected dementia. Scores on the Competence Scale, a measure of functional daily living skills, were correlated .72 with Full Scale IQs and .77 with Verbal IQs and moderately correlated (.55) with Performance IQs. A number of significant correlations were found between WAIS--R subtests and subscales of the competence instrument. Means and standard deviations for the 10 Competence subscale and total scores are presented.

Activities of Daily Living↗
PubMed1988

Quality of life following treatment: a preliminary study of in- and outpatients with chronic pain.

Using a combination of standardized and Likert-type measures of health, disability, and psychological adjustment, this study compared the quality of life reported by thirty-seven inpatients and thirty-six outpatients approximately eight months after completing treatment. While both patient groups reported treatment-related changes, inpatients were significantly more dysfunctional than outpatients both before and after treatment. The pattern of perceived improvement among inpatients reflected particular changes in narcotic use and in "up" time. For outpatients, the pattern of change pointed to increased periods of activity. The data are interpreted to reflect the need for treatments that are tailored to meet the differing levels of dysfunction of patients who present with chronic pain syndromes. Methodological problems of this and other clinical studies that compare treatment effects on patients demonstrating different levels of dysfunction are discussed.

Adult↗
PubMed1988

Compensation status and symptoms reported by patients with chronic pain.

This study examined the initial symptoms of patients with chronic pain who were (n = 70) or were not (n = 52) involved in some aspect of the compensation system--worker's compensation, litigation, or Social Security Disability Insurance. Analyses indicated that compensation patients were discriminable from noncompensation patients (p less than 0.0001). Compensation patients were younger and less likely to be female; they also tended to report fewer surgeries, shorter pain durations, and more vocational and sexual disability. Finally, they perceived their medical conditions to be more severe than had been diagnosed by physicians. The groups did not seem to differ in severity of pain or psychologic distress. These data are consistent with studies indicating that compensation patients are not "symptom magnifiers," although the data do indicate that the life disruptions reported by these patients may be greater than those reported by patients not involved in compensation systems.

Adult↗
PubMed1987

Status of behavioral medicine in American and Canadian medical training.

This article reports a survey of attitudes and current practices regarding behavioral medicine in American and Canadian medical school departments of psychiatry. Participants were eighty-two chairpersons of departments of psychiatry. Five major areas were addressed concerning the existence, location, and composition of behavioral medicine faculty and their contribution to training and research programs. Results indicate that behavioral medicine is represented in the majority of medical schools and teaching hospitals. Faculty tended to be located in psychiatry. A majority of the respondents did not think that behavioral medicine should be considered a separate clinical specialty area, but in actual practice behavioral medicine was distinct from consultation/liaison psychiatry as often as integrated with it. The analysis of subjects and methods taught in residency training programs suggested a meaningful trend in the data. The implications of these results for models underpinning traditional medical education and psychosomatic medicine are discussed.

Administrative Personnel↗
PubMed1987

The Pain Disability Index: psychometric and validity data.

The Pain Disability Index (PDI) is a brief instrument that was developed to assess pain-related disability, providing information that complements assessment of physical impairment. This paper presents the results of two studies concerning the psychometric properties and the validity of the PDI. In study I, PDI scores of 108 patients appeared internally consistent (alpha = .86), although a factor analysis revealed two factors. The first factor (59.3% of variance) seemed to include more discretionary, less obligatory activities. The second factor (14.3% of variance) included activities more basic to daily living and survival. Study II found that the PDI scores of 37 former inpatients were significantly higher than 36 former outpatients who responded to a follow-up questionnaire. These findings support the validity of the PDI. Several methodologic issues are discussed, and suggestions are made for future uses of the instrument.

Adult↗
PubMed1986

A cross-validation of two short forms of the WAIS-R in a geriatric sample suspected of dementia.

This study investigated two short forms of the Wechsler Adult Intelligence Scale-Revised reported by Silverstein (1982). The short form IQs were calculated from test data of 42 geriatric patients with suspected dementia. The short form IQs were compared to the actual Full Scale IQs. Correlations between the two and four subtest short forms and the actual IQs were .93 and .96, respectively. In addition, the two subtest short forms correctly classified 67% of the sample on the basis of Wechsler's intelligence categories, and the four subtest short forms correctly classified 83% of the sample. It was concluded that these short forms should not be used when a precise IQ assessment is required; however, they may be useful for various screening purposes.

Aged↗
PubMed1986

Age differences in the commonality of free associations.

Commonality of associative response provides an index of the organization of semantic memory. The present study investigated age differences in semantic organization by comparing commonality of associative response. Thirty young (M = 20 yrs) and 30 old (M = 72 yrs) adults gave free associations to single stimulus words of high or low linguistic frequency. Controlling statistically for education and verbal skills, it was determined that there were no age differences in the commonality or variability of associates. Results are discussed in reference to developmental trends in the organization of semantic memory.

Adolescent↗
PubMed1985

Psychological assessment in chronic pain.

Assessment of psychological status in chronic pain patients is an important aspect of evaluation and treatment in pain management programs. Unfortunately, most of the psychological tests used in common practice have not been used extensively with chronic pain patients. Normative and comparative data must be generated to allow for valid and efficient psychometric assessment. The present paper is a preliminary comparison of several instruments of potential usefulness in the assessment of anxiety and depression among pain patients (N = 34). The SCL-90-R appeared to offer the best combination of relevant data and efficient assessment. However, it was noted that there were significant intercorrelations among the SCL-90-R subscales, which suggests a unitary factor structure.

Adult↗
PubMed1985

Parallel-form reliability of the Wechsler Memory Scale in a geriatric population with suspected dementia.

The present study examined parallel-form reliability of the Wechsler Memory Scale (WMS) in a population where such forms are particularly useful, that is, among patients who are suspected of having some type of dementing illness. Comparative analyses were made for total raw scores. Memory Quotient (MQ) scores, and individual subtest scores. Thirty geriatric patients originally referred for neuropsychological testing because of suspected dementia were given both Forms 1 and 2 of the WMS. The results yielded high overall reliability coefficients for MQ and total raw scores. Individual subtest scores also yielded rather high coefficients, and only one subtest (Associate Learning) had a significant mean difference. Apparently, the two forms have sufficient parallel-form reliability to be considered clinically interchangeable. Thus, the WMS may be a useful tool for repeat evaluations of memory functioning in a demented population.

Aged↗